| NPI | 1073963278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05074) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS019838) |
| 207Q00000X Family Medicine (Licence: IA R-10664) | |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2024-01-04 |